A keen boxer has opened up about his health fight after he was left almost blind in one eye after overusing eye drops for 20 years.
Paul Awah, a sports coach who has lived in Dubai for 11 years, was prescribed steroid eye drops in his home country of Cameroon in his 20s. He continued to take the same medication until last year when a routine eye test diagnosed a rare case of steroid-induced glaucoma that required urgent medical intervention.
His sight had deteriorated to around 3 per cent in one eye, and he would have gone completely blind on his left side unless he opted for surgery. “I went surfing in Dubai, but when I got out of the water, I could feel a little heaviness and dizziness on my eye and it felt like there was a blockage there,” said Mr Awah, 39.
“I went to the hospital, and they did a diagnosis and a basic eye check-up, then gave me prescription glasses and eye drops. When the glasses weren't working, and my eyesight was still not getting better I went to another hospital.
“The doctor there told me I had advanced glaucoma, and only about 4 or 5 per cent vision on the left eye. About 95 per cent of the vision is gone and my optic nerves are already all damaged.”
Ageing populations
Glaucoma is a group of eye conditions that damage the optic nerve, and is usually diagnosed in those over 60.
Due to his young age and the years he had spent boxing, doctors suspected the damage may have been caused by head trauma. When he told medics his history with eye drops, it became clear that was the probable cause of his condition.
“I've been having this itchiness since I was 20 or so when I was in Cameroon and they just gave me eye drops, which could have done the damage,” said Mr Awah. “It looks like I did a steroid overdose, and instead of fixing my eyesight it destroyed my optic nerve. They call glaucoma the silent thief of sight, and I can understand why.”
Raised eye pressure happens as a result of a build-up of fluid that flows throughout the inside of the eye. This fluid, called the aqueous humour, usually drains through a tissue located at the angle where the iris and cornea meet.
Normal eye pressure is usually considered to be between 10 and 20 millimetres of mercury (mmHg). Having eye pressure that is too low or too high can damage vision. Special eye drops can usually help reduce the build-up of eye pressure, but if it is diagnosed too late – as in Mr Awah's case – there is little doctors can do and the damage is permanent.
They did, however, perform minor surgery by implanting a stent – a tiny balloon similar to those used in a heart procedure to improve blood flow – to relieve the pressure and prevent further vision loss, or a lifetime of medication.
Dr Nandini Sankarnaryanan, a specialist ophthalmologist at Medcare Eye Centre, picked up his diagnosis during a routine eye exam.
“Steroids are used for many things, but when they are used for a very long time without any supervision, it can result in increased eye pressure and this kind of condition,” said Dr Sankarnaryanan. For a young person like Paul to have a glaucoma, other reasons come into the picture like history of trauma, congenital glaucoma or a family history – steroid use is another factor.
“Whenever any steroid is given it should come with the caveat to be used under supervision and only for the prescribed duration. Technically when these medicines are prepared, once you open the bottle, it should be used up within a particular duration of time, say four to six weeks. We need to stick to those guidelines.”
January is Glaucoma Awareness Month, a global campaign to highlight glaucoma, which is a leading cause of irreversible blindness.
Regular check-ups
The initiative encourages regular eye check-ups, especially for those at higher risk such as older adults, people of African or Hispanic descent, and those with a family history, to catch the disease before significant vision loss occurs.
It can be managed with early detection through comprehensive dilated eye exams. The condition affects an estimated 80 million people worldwide, and that number is expected to rise with ageing populations.
Other eye problems, such as myopia – or short sightedness – are also on the rise, particularly in children, partly due to increasing screen time and eye strain.
Routine eye tests should begin between the ages of three and five. If everything is normal, a person does not need to undergo a test every year. But if there is any family history of eye problems, annual check-ups are a must.
Between the ages of 18 and 40, a check-up once every two years is enough, although if you have conditions such as high blood pressure, diabetes or high cholesterol, you must also have an annual eye check-up, which includes a retina exam.
“Glaucoma affects the optic nerve in the eye, and the nature of glaucoma is that it's a silent disease, meaning it doesn't come with symptoms,” said Dr Sankarnaryanan. “It may be there and you may not be aware of it. Whatever damage has happened cannot be recovered, but further damage can be prevented.
“Some patients have never had a retina check-up at all in their life. This is the reason why many things get missed.”
